Individual
JAEWON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 KNEELAND ST, BOSTON, MA 02111-1527
(617) 636-6531
Mailing address
44 2ND ST, CAMBRIDGE, MA 02141-1735
(617) 571-2588
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DL101121
MA
Other
Enumeration date
08/22/2025
Last updated
08/29/2025
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